A Race Against Time: Saddle Pulmonary Embolism Following Pelvic Trauma - A Tale of Teamwork and Tenacity in a Resource-Limited Setting

A 72-year-old male polytrauma patient with pelvic and femoral fractures secondary to a high-velocity motor vehicle collisiondeveloped acute hemodynamic instability and refractory hypoxia six hours post-admission, prompting emergent ComputedTomography Pulmonary Angiography (CTPA), which revealed a life-threatening saddle Pulmonary Embolism (PE) occludingthe pulmonary artery bifurcation. Immediate therapeutic anticoagulation with Low-Molecular-Weight Heparin (LMWH)was initiated while a multidisciplinary team implemented aggressive hemodynamic optimization, including judicious fluidresuscitation, vasopressor support and continuous invasive monitoring to mitigate right ventricular failure and circulatorycollapse. This case underscores the critical importance of maintaining a high index of suspicion for Venous Thromboembolism(VTE) in trauma patients, particularly those with pelvic fractures and highlights the essential role of rapid interdisciplinarycollaboration, structured risk stratification and resource-adaptive management strategies in improving outcomes for this timesensitive, high-mortality condition.